Medicaid must be changed

Sunday

The Missouri General Assembly ended its session after failing to act on a rare opportunity to transform Medicaid. For the good of Missouri, however, this critically needed transformation must proceed.

Missourians cannot afford a lengthy delay — 300,000 of our neighbors remain uninsured, including more than 13,000 veterans and 4,000 spouses of veterans who live below or near the federal poverty level. Unfortunately, Missourians' tax dollars will be spent by other states on their versions of Medicaid reform as Missouri businesses and individuals pay more.

This year's inaction means Missouri will have a weaker mental health screening and treatment system, shifting the burden to law enforcement. The cost of uncompensated care at hospitals, which was more than $1 billion in 2011, will remain and grow. These costs will continue to be shifted to those with health insurance, who will be charged higher premiums.

So the legislative inaction is not just a disappointment — for many, it is devastating. That is why the case for Medicaid reform remains strong — the needs are real and immediate.

These needs are recognized by the broad coalition of groups that endorsed this year's Medicaid reform effort. The coalition in support of Medicaid transformation is robust and will keep growing — sadly, because of pain that is sure to come. Already, Missouri health care providers are assessing areas in which to reduce or eliminate services because of this year's inaction in Jefferson City. An anxious spring has implications for a grim summer and fall, with the possibility of reduced hospital services, layoffs and reduced spending on capital investments that support jobs throughout the economy.

Across our state, hospitals' uncompensated care costs will continue to grow. Without Medicaid reform, these costs are projected to rise to more than $3.5 billion per year by the end of the decade. In the federal budget year that starts Oct. 1, hospitals will face significant losses through payment cuts from Medicare and Medicaid without new revenue from Medicaid coverage designed to offset those cuts. This will inhibit growth in both the health sector and throughout the economy, and it will weaken hospitals' ability to provide vital services to their communities.

For example, just outside Kansas City, Liberty Hospital last week announced it would lay off 129 employees, close its wound clinic and eliminate a hospital-funded transportation program for patients. Meanwhile, Heartland Health in St. Joseph has alerted local officials that without increased enrollment through Medicaid, it can no longer subsidize $1.7 million a year in ambulance losses and will end its ambulance service.

Missouri needs a Medicaid reform plan that brings the most value for our state, including returning our citizens' hard-earned tax dollars from Washington and addressing the health care needs of Missourians. Let's focus on what we can accomplish. By next year, we must commit to building a better Medicaid system. We can do this by reducing costs and improving beneficiaries' health through more effective delivery and management of care.

Missouri's hospitals will work tirelessly in the interim with lawmakers and stakeholders to deliver such a Medicaid transformation plan for action next session. We must look to the future and work to inform leadership on Medicaid reform as the Missouri House and Senate study the issues of Medicaid between now and the 2014 legislative session. In the interim, we will continue to educate all parties about the necessity of, and the opportunity presented by, Medicaid reform.

This issue is too important, and inaction is not an option.

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